The proposed studies will include investigations into the mechanisms, etiologic factors and management of congestive heart failure and the role of the peripheral circulation, especially the veins, in congestive heart failure (CHF). These studies will be conducted by rheoplethysmography, venous pressure measurements in intact isolated forearm venous segments, arterial pressure measurements and clinical observations. The effect of neurogenic and psychogenic factors on the peripheral circulation in CHF will be studied using these same techniques, as well as before and after sympathetic nerve blocking. CHF is a serious and common disease, and we lack much information for prevention and proper management. The peripheral circulation will also be studied in various peripheral vascular diseases. In these instances, too, the influence of neurogenic, psychogenic, climatic and other factors will be investigated. Pathologic changes observed electron microscopically and histologically in digital biopsy specimens will be correlated with rheoplethysmographic recordings of digital circulation when possible. BIBLIOGRAPHIC REFERENCES: Burch, G.E., Leon-Galindo, J. and Cronvich, J.A.: "New" Treatment for Chronic Intractable Congestive Heart Failure. Am. Heart J. 91:735, 1976. Burch, G.E. and Giles, T.D.: Cardiomyopathy: Diagnostic Criteria and Classification, In Controversy in Cardiology, E.K. Chung (ed.), New York, Springer-Verlag, 1976.